It was a wheeze and a whistle that led parents in India to take their four-year-old son to the doctor.
He had been coughing persistently for two days, and every so often, his breathing was punctuated with a high-pitched whistle.
According to a case study published Wednesday in the New England Journal of Medicine, aside from the cough, the boy felt fine. He had no signs of a viral infection in his upper respiratory tract and no history of any problems.
When doctors did a physical exam, they found no obvious problems aside from an “expiratory wheeze” in his middle and lower left lung – meaning a continuous, high-pitched whistle that often indicates some kind of airway obstruction.
So doctors took an X-ray of the boy’s chest. This is when they started to narrow in on the problem. The boy’s left lung was hyperinflated – a sign that the air wasn’t getting out properly, which is often caused by a foreign object in the lung. Although they couldn’t see what was in there, they decided to go in.
They performed a rigid bronchoscopy, sliding a camera and instrument into the boy’s airway to take a look. They came out with a white plastic toy whistle that was lodged in the boy’s lung.
He had been playing with a whistle before he started coughing in the first place, his parents said. Now, they knew what happened to it.
Foreign body aspiration, or having foreign objects lodged in the lungs or trachea is a common problem, according to an article in the Postgraduate Medical Journal. Most cases are in toddlers, and they usually involve food, like nuts, seeds and bones. It can be a very serious issue, even leading to death. Aspiration is the fourth leading cause of injury hospitalizations and death in children under four, according to the Canadian Paediatric Society.
Thankfully, another X-ray taken the next day showed that the boy’s lung was back to normal. A year later, he was still doing fine, though maybe was more careful around whistles.
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